PMID- 28938965
OWN - NLM
STAT- MEDLINE
DCOM- 20170929
LR  - 20181202
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 192
DP  - 2017 Oct
TI  - Impact of atrial fibrillation on outcomes of patients treated by transcatheter
      aortic valve implantation: A systematic review and meta-analysis.
PG  - 64-75
LID - S0002-8703(17)30204-1 [pii]
LID - 10.1016/j.ahj.2017.07.005 [doi]
AB  - BACKGROUND: Conflicting data have been reported related to the impact of atrial
      fibrillation (AF) on the outcomes after transcatheter aortic valve implantation
      (TAVI). We aimed to assess the prognosis of TAVI-treated patients according to
      the presence of pre-existing or new-onset AF. METHODS: Studies published between 
      April 2002 and November 2016 and reporting outcomes of pre-existing AF, new-onset
      AF, or sinus rhythm in patients undergoing TAVI were identified with an
      electronic search. Pairwise and network meta-analysis were performed. Outcomes of
      interest were short- and long-term mortality, stroke, and major bleeding.
      RESULTS: Eleven studies (11,033 individuals) were eligible. Compared to sinus
      rhythm, short-term and long-term mortality were significantly higher in new-onset
      AF (short-term OR 2.9, P=.002; long-term OR 2.3, P<.0001) and pre-existing AF
      groups (short-term OR 2.7, P=.004; long-term OR 2.8, P<.0001). Compared to sinus 
      rhythm, new-onset AF increased the risk of stroke at early (OR 2.1, P<.0001) and 
      late follow-up (OR 1.92, P<.0001), and the risk of early bleedings (OR 1.65,
      P=.002), while pre-existing AF increased the risk of late stroke (OR 1.3,
      P=0.03), but not the risk of bleeding. Compared to pre-existing AF, new-onset AF 
      correlated with higher risk of early stroke (OR 1.7, P=.002) and major bleedings 
      (OR 1.7, P=.002). CONCLUSIONS: AF is associated with impaired outcomes after
      TAVI, including mortality, stroke and (limited to new-onset AF) major bleedings. 
      Compared to pre-existing AF, new-onset AF correlates with higher risk of early
      stroke and major bleedings. Improved management of AF in the TAVI setting,
      including tailored antithrombotic treatment strategies, remains a relevant need.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Mojoli, Marco
AU  - Mojoli M
AD  - Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences,
      University of Padua Medical School, Padua, Italy.
FAU - Gersh, Bernard J
AU  - Gersh BJ
AD  - Division of Cardiovascular Diseases, Mayo Clinic and Mayo Clinic College of
      Medicine, Rochester, MN, USA.
FAU - Barioli, Alberto
AU  - Barioli A
AD  - Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences,
      University of Padua Medical School, Padua, Italy.
FAU - Masiero, Giulia
AU  - Masiero G
AD  - Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences,
      University of Padua Medical School, Padua, Italy.
FAU - Tellaroli, Paola
AU  - Tellaroli P
AD  - Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular
      Sciences, University of Padua Medical School, Padua, Italy.
FAU - D'Amico, Gianpiero
AU  - D'Amico G
AD  - Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences,
      University of Padua Medical School, Padua, Italy.
FAU - Tarantini, Giuseppe
AU  - Tarantini G
AD  - Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences,
      University of Padua Medical School, Padua, Italy. Electronic address:
      giuseppe.tarantini.1@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20170715
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - AIM
SB  - IM
MH  - Aortic Valve Stenosis/complications/surgery
MH  - Atrial Fibrillation/*complications
MH  - Electrocardiography
MH  - Global Health
MH  - Heart Rate/*physiology
MH  - Humans
MH  - Incidence
MH  - Prognosis
MH  - Stroke/*epidemiology/etiology
MH  - Transcatheter Aortic Valve Replacement
EDAT- 2017/09/25 06:00
MHDA- 2017/09/30 06:00
CRDT- 2017/09/24 06:00
PHST- 2017/01/20 00:00 [received]
PHST- 2017/07/11 00:00 [accepted]
PHST- 2017/09/24 06:00 [entrez]
PHST- 2017/09/25 06:00 [pubmed]
PHST- 2017/09/30 06:00 [medline]
AID - S0002-8703(17)30204-1 [pii]
AID - 10.1016/j.ahj.2017.07.005 [doi]
PST - ppublish
SO  - Am Heart J. 2017 Oct;192:64-75. doi: 10.1016/j.ahj.2017.07.005. Epub 2017 Jul 15.